T Nikravesh MD Corporation

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

T NIKRAVESH MD CORPORATION

Practice address

6404 Wilshire Blvd Ste 600
Los Angeles, CA 90048-5508

Phone

(310) 659-2226

Fax

(323) 782-8528

NPI assigned

Aug 11, 2006

Last updated

Apr 30, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tannaz Nikravesh, MDNPI 1386685774

Title

President

Phone

(310) 659-2226

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tannaz Nikravesh, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Los Angeles, CA
  • NPI 1386685774
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1730190901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6404 WILSHIRE BLVD STE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485508",
            "telephone_number": "310-659-2226",
            "fax_number": "323-782-8528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6404 WILSHIRE BLVD STE 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485508",
            "telephone_number": "310-659-2226",
            "fax_number": "323-782-8528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T NIKRAVESH MD CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "NIKRAVESH",
        "authorized_official_first_name": "TANNAZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-659-2226",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.